Surgical instrument cleaning arrangement

ABSTRACT

The instrument cleaning apparatus of the present disclosure facilitates the cleaning of a scope inserted through a sealed portal during a surgical procedure by providing a cleaning solution within the operating cavity so that the surgical instrument doesn&#39;t have to be removed therefrom. In an embodiment, a surgical access device is provided with a housing, a sleeve extending distally from the housing, and a conduit disposed in mechanical cooperation with the sleeve. The sleeve defines a longitudinal axis and is dimensioned for passage through a tissue tract. The sleeve also defines a longitudinal bore for reception and passage of a surgical instrument. The conduit has a first portion configured to receive a fluid and a second portion configured to discharge the fluid. In another embodiment, an instrument cleaning apparatus includes a base portion and a fluid retention portion. The base portion includes a substantially tubular wall having a proximal end and a distal end and a longitudinal passageway extending therethrough. The fluid retention portion is in mechanical cooperation with the base portion and is adapted to retain a cleaning fluid therein.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 61/287,894 filed on Dec. 18, 2009, theentire contents of which are incorporated herein by reference.

BACKGROUND

1. Field of the Disclosure

The present disclosure relates to surgical devices and, moreparticularly, relates to an instrument cleaner adapted for cleaning aninstrument while the instrument is within a sealed surgical portalapparatus during a minimally invasive, e.g., a laparoscopic, surgicalprocedure.

2. Description of the Related Art

Minimally invasive surgical procedures, including both endoscopic andlaparoscopic procedures, permit surgery to be performed on organs,tissues and vessels far removed from an opening within the tissue.Laparoscopic and endoscopic procedures generally require that anyinstrumentation inserted into the body be sealed, e.g., provisions maybe made to ensure that gases do not enter or exit the body through theincision as, for example, in surgical procedures in which the surgicalregion is insufflated. Particularly, a viewing scope may be introducedinto the body through a sealed portal, such as a cannula, in order forthe surgeon to view the region being treated on a video monitor and tosee any of a variety of surgical instruments introduced either directlyor through other portals into the surgical region.

In procedures that employ the internal introduction of a scope, lenssmudging and/or other visual obstructions, such as fogging, can occur toobscure the surgeon's view. Known cleaning methods generally requirethat the scope be pulled completely out of the portal so that the lenscan be cleaned and then re-inserted. It would be advantageous to be ableto clean the lens while the scope is still inserted into the sealedportal.

SUMMARY

The present disclosure relates to an instrument cleaning apparatus whichfacilitates the cleaning of a scope inserted through a sealed portalduring a surgical procedure by providing a cleaning arrangement, e.g., acleaning solution, within the operating cavity so that the surgicalinstrument need not be removed therefrom.

In an embodiment, a surgical access device is provided with a housing, asleeve extending distally from the housing, and a conduit disposed inmechanical cooperation with the sleeve. The sleeve defines alongitudinal axis and is dimensioned for passage through a tissue tract.The sleeve also defines a longitudinal bore for reception and passage ofa surgical instrument. The conduit has a first portion configured toreceive a fluid and a second portion configured to discharge the fluid.The second portion of the conduit is in mechanical cooperation with thesleeve.

The second portion of the conduit may be configured as a nozzle. Inembodiments, the second portion of the conduit is configured as aproximally facing nozzle. The elongated portion of the conduit,positioned between the first and second portions, may be disposedadjacent to the sleeve. In other embodiments, the elongated portion isdisposed within a wall of the sleeve.

Methods of using and cleaning a surgical instrument with the surgicalaccess device are also disclosed. In accordance with the presentmethods, a trocar assembly is provided having a conduit operably coupledto a sleeve of the trocar assembly. The conduit includes a first portionfor receiving a fluid and a second portion for discharging the fluid.The fluid may be passed from a fluid source into the first portion ofthe conduit. A surgical instrument is inserted through the trocarassembly to access a surgical site where a surgical function may beperformed with the surgical instrument. Fluid is discharged from thesecond portion of the conduit to contact a distal-end of the surgicalinstrument.

In another embodiment, an instrument cleaning apparatus includes a baseportion and a fluid retention portion. The base portion is adapted forpositioning on a surgical instrument and includes a substantiallytubular wall having a proximal end and a distal end and a longitudinalpassageway extending therethrough. The fluid retention portion is inmechanical cooperation with the base portion and is adapted to retain acleaning fluid therein.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present disclosure will be better appreciated byreference to the drawings wherein:

FIG. 1 is a perspective view of a surgical access device in the fowl ofa portal and conduit in accordance with the principles of the presentdisclosure;

FIG. 2 is a longitudinal cross-sectional view of an alternate embodimentof the surgical access device of FIG. 1 having a conduit incorporatedinto a sleeve of a portal;

FIG. 3 is a longitudinal cross-sectional view of another embodiment ofthe surgical access device of FIG. 1 having a conduit adjacent a sleeveof a portal;

FIGS. 4A and 4B are transverse cross-sectional views of embodiments ofthe conduit of the surgical access device of FIGS. 1-3;

FIG. 5 is a side view of a surgical access device of FIG. 1 coupled to afluid source in accordance with the principles of the presentdisclosure;

FIG. 6 is a perspective view of a scope cleaner having a base portionand fluid retention portion in accordance with the principles of thepresent disclosure;

FIGS. 7A and 7B are transverse cross-sectional view of embodiments ofthe base portion of the scope cleaner of FIG. 6;

FIG. 8 is an alternate embodiment of a scope cleaner of FIG. 6; and

FIG. 9 is an embodiment of the scope cleaner of FIG. 6 attached to asurgical instrument.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The scope cleaner of the present disclosure facilitates the cleaning ofa scope inserted through a sealed portal during a surgical procedure byproviding a cleaning solution within the operating cavity so that thesurgical instrument doesn't have to be removed therefrom. Inembodiments, the sleeve of a portal apparatus includes a conduit fordispensing the cleaning solution onto the lens of the scope. In otherembodiments, the cleaning solution is pre-disposed on a detachableapparatus which may be fastened to an external surface of a surgicalinstrument upon which a scope may be contacted and cleaned. In otherembodiments, the cleaning solution is pre-disposed on an apparatus whichis integrally formed onto an external surface of a surgical instrumentupon which a scope may be contacted and cleaned. In still otherembodiments, the cleaning arrangement includes a detachable orundetachable absorbent apparatus which may be fastened to, or which isintegrally formed with, an external surface of a surgical instrumentupon which a scope may be contacted and cleaned, e.g., by the absorbentmaterial absorbing any fluids, fog, etc., that is disposed on the scope.

While the device according to the present disclosure is especiallysuitable for cleaning surgical scopes, it is envisioned that the devicecan be used in connection with the cleaning of other surgicalinstruments which are introduced through a surgical portal. Examples ofsurgical instrumentation which may be introduced through the portalinclude clip appliers, graspers, dissectors, retractors, staplers, laserprobes, photographic devices, tubes, electrosurgical cutting,coagulating, and ablation devices, and other tools within the purview ofthose skilled in the art.

Referring now to the drawings, in which like reference numerals identifyidentical or substantially similar parts throughout the several views,FIG. 1, in conjunction with FIGS. 2 and 3, illustrate an embodiment ofthe scope cleaner of the present disclosure. Surgical access device 10of the present disclosure incorporates conduit 20 with portal 30. Portal30 may be any device suitable for the intended purpose of accessing abody cavity, such as a trocar or cannula assembly, through a tissuetract.

Portal 30 may be used in a variety of surgical applications and isparticularly adapted for use in laparoscopic surgery where theperitoneal cavity is insufflated with a suitable gas, e.g., CO₂, toraise the cavity wall from the internal organs therein. Portal 30 istypically used with an obturator assembly (not shown) which may be ablunt, a non-bladed, or a sharp pointed instrument positionable withinthe passageway of portal 30. The obturator assembly is utilized topenetrate the abdominal wall or introduce portal 30 through theabdominal wall, and then subsequently is removed from portal 30 topermit introduction of scope 60 utilized to perform the procedurethrough the passageway.

The scope 60 may be any of a variety of laparoscopes and endoscopes,such as, for example, arthroscopes, thoracoscopes, bronchioscopes,hysteroscopes, choledochoscopes, cystoscopes, restectoscopes, and thelike, depending on the surgical procedure being performed.

Portal 30 includes sleeve 32 having proximal (or leading) and distal (ortrailing) ends 34 and 36, respectively, and housing 38 mounted toproximal end 34 of sleeve 32. Sleeve 32 defines a longitudinal axis “t”extending along the length of sleeve 32 and defines an internallongitudinal bore or passage 35 dimensioned to permit passage of scope60.

Housing 38 includes central aperture 39 arranged about axis “t” and sealassembly 40. Central aperture 39 is configured and dimensioned to permitentry of scope 60. Seal assembly 40 defines a seal assembly opening 42within seal 45, seal assembly opening 42 being in general alignment withthe central aperture 39 of housing 38. Seal assembly opening 42 isconfigured and dimensioned such that insertion of scope 60 into sealassembly opening 42 causes the material defining seal 45 to engage theouter surface of scope 60 in a substantially fluid tight manner tominimize the formation of gaps around scope 60 and prevent gases fromescaping.

In embodiments seal assembly opening 42 may include a slit which isadapted to close in the absence of a surgical object and/or in responseto insufflation gases of the pressurized cavity. It is also envisionedthat seal 45 of seal assembly 40 may be fabricated from a relativelyrigid biocompatible polymeric material or alternatively, from aresilient and/or flexible material such as a fabric, foam, elastomericmaterial, or combinations thereof in order to bend or deform about aninserted scope 60 while absorbing off-axis motion.

Conduit 20 is operably coupled to portal 30. Conduit 20 may be joinedwith any part of sleeve 32, including its inner or outer surface asillustrated in FIGS. 2 and 3, respectively. Conduit 20 includes opening22 on proximal end 24 and nozzle 26 on distal end 28. Conduit 20 definesa longitudinal axis “a”, as shown in FIG. 3, extending along the lengthof conduit 20 and defines an internal longitudinal channel 29dimensioned to permit the flow of fluid therethrough. In embodiments,longitudinal axis “a” may be substantially parallel to axis “t” ofsleeve 32.

The size and dimension of channel 29 of conduit 20 may vary. Inembodiments, channel 29 may be uniform in size and diameter along thelength of conduit 20. A change or decrease, however, in the surface areaof channel 29 may aid in discharging fluid through nozzle 26. Therefore,in other embodiments, channel 29 may taper towards distal end 28 ofconduit 20. It is also envisioned that channel 29 may be comprised ofsmaller channels 29′ and 29″ as illustrated in FIGS. 4A and 4B,respectively. By decreasing the diameter of channel 29 through whichfluid may flow, the resistance of the fluid increases. Pressure isthereby built up for the discharge of the fluid through nozzle 26.

Proximal opening 22 of conduit 20 is configured to connect to fluidsource 50. Opening 22 and fluid source 50 may be connected by tubing orother means as is within the purview of those skilled in the art. Fluidsource 50 may be a syringe as illustrated in FIG. 5. Fluid source 50 mayinclude syringes, pumps, valves, and the like which may be pressurizedor un-pressurized. Nozzle 26 opens into distal end 36 of longitudinalpassage 35 of sleeve 32 of portal 30. Nozzle 26 may be a spigot, spout,or any other opening for discharging and/or spraying fluid 52 receivedby opening 22 from fluid source 50. It is envisioned that nozzle 26faces proximally, such that at least a portion of the projected spray offluid 52 from nozzle 26 is proximal to the distal-most end of sleeve 32.

Nozzle 26 may include one or more openings or include a series orpattern of openings conducive to applying and washing surgicalinstrumentation 60. In embodiments, nozzle 26 may evenly distributefluid 52 across a predetermined area or focus fluid 52 into one or moreregions. In embodiments, nozzle 26 may include openings of varying sizesand/or angles in order to provide additional resistance to fluid 52 fora more forceful or jet-like flow of fluid 52 or to direct flow of fluid52.

Fluid 52 may be a washing or rinsing fluid such as saline or sterilewater. Fluid 52 may be an anti-fogging solution or may be warmed toreduce the likelihood of fogging. Defogging solutions may be water,glycol, and water soluble wetting agents. In embodiments, fluid 52 iscommercially available surgical anti-fog solution FRED™ available fromCovidien (Mansfield, Mass.). Fluid 52 may contain a biocompatiblecleaning agent or a bioactive agent that has clinical use.

Surgical access device 10 may be a single monolithically formed unit orcomposed of several components connected to each other throughconventional means including a bayonet coupling, a threaded connection,snap fit, ultrasonic welding or any other means envisioned by oneskilled in the art including, e.g., adhesive means. Sleeve 32 andhousing 38 of portal 30 may be a monolithically formed unit or may beconnected to each other through conventional means as described above.In a like manner, sleeve 32 of portal 30 and conduit 20 may bemonolithically formed or may be connected to each other throughconventional means. Surgical access device 10, including conduit 20and/or portal 30, may be formed of any suitable medical grade material,such as stainless steel or other rigid materials, including polymericmaterials, such as polycarbonate and the like. Surgical access device 10may be transparent, translucent, or opaque.

To use the scope cleaner in connection with the performance of asurgical task during a laparoscopic procedure, the peritoneal cavity isinsufflated to establish the pneumoperitonum. Surgical access device 10is introduced into an insufflated abdominal cavity typically utilizing asharp or non-blade trocar obturator to access the cavity and theobturator is removed. A scope 60 is advanced through surgical accessdevice 10 by inserting instrument 60 into central aperture 39 of housing38 and through seal assembly 40 whereby seal assembly 40 accommodatesinstrument 60 in substantial sealed relation therewith. Scope 60 isdistally passed through seal assembly 40, longitudinal passage 35, andinto the body cavity. The desired surgical task is performed with scope60. During manipulation of scope 60, should scope 60 fog, become soiled,accumulate debris, or obstruct the surgeon's view in any way, scope 60is adjusted within sealed portal 30 so that the soiled part of scope 60,e.g., the lens, is substantially aligned with the projected spray offluid 52 from nozzle 26. Fluid 52 is then passed through channel 29 ofconduit 20 and out through nozzle 26 in order to spray and clean scope60.

Turning now to FIG. 6, the scope cleaner 70 may be an apparatus whichmay be detachably secured to the outer surface or shaft of a surgicalinstrument 62, such as the sleeve of a trocar assembly or any otherinstruments which are introduced into a surgical cavity during aminimally invasive surgical procedure as discussed above. Inembodiments, scope cleaner 70 is attached to a surgical instrument 62which remains in the surgical cavity for an extended period of time,such as a tissue grasping instrument.

Scope cleaner 70 includes a base portion 80 and a fluid retentionportion 90. Base 80 has a tubular configuration and includes wall 82.Wall 82 includes proximal end 84 and distal end 86 and defines aninternal longitudinal opening 88 extending along the entire length, fromthe proximal end 84 to the distal end 86, of wall 82. Wall 82 may becontinuous as illustrated in FIG. 7A or may have a longitudinallyextending slit 81 formed therein, as illustrated in FIG. 7B.

Wall 82 may be formed from a flexible polymer and/or elastomericmaterial, such as, for example, polyolefins such as polypropylene andpolyethylene, polyesters such as polyethylene terephthalate, polyamidessuch as nylon, polyurethanes, silicones, vinyl, and rubber. The flexiblematerials are adaptable and amendable for insertion onto a surgicalinstrument 62. Wall 82 must have a sufficient elasticity to bend anddeform upon placement onto the shaft of surgical instrument 62 whileconforming about the outer dimensioning of the surgical instrument 62. Agrip or tab 83 may be added to base 80, such as at proximal end 84 asillustrated in FIG. 6, to assist in inserting the scope cleaner 70 aboutinstrument 62. Tab 83 radially extends around and is raised from aportion of wall 82 to facilitate gripping by the hand of the holder.

In other embodiments, wall 82 is formed from a relatively rigidmaterial, such as plastics. Plastics may be formed from polymers such asthose described above. In embodiments, the wall is formed from a highdensity polymer and includes a longitudinally extending slit asdescribed above to facilitate snap fitting of the scope cleaner onto asurgical instrument. It is contemplated that the scope cleaner could beassembled with the surgical instrument during manufacturing of theinstrument.

Fluid retention portion 90 is in mechanical cooperation with baseportion 80. Fluid retention portion 90 may be integrated into wall 82 ofbase 80 or may be attached to the outer surface of wall 82. Inembodiments, the fluid retention portion is sufficiently thin so thatthe scope cleaner 70 maintains a substantially uniform diameter alongthe length thereof. As illustrated in the current embodiment, fluidretention portion 90 is a pad fastened to the surface of wall 82 byconventional coupling means, such as by the use of adhesives. In otherembodiments, such as that illustrated in FIG. 8, the fluid retentionportion 92 has a basket-like configuration which protrudes from theouter surface of wall 82. As illustrated in this embodiment, the portionof the scope cleaner 70 upon which the fluid retention portion 92 isretained has an extended diameter. Fluid retention portion 92 must bemade of a flexible material so that is will flex during insertion andwithdrawal of the instrument on which it is applied during a surgicalprocedure.

Fluid retention portion 90 is adapted and configured to allow for theretention of fluid 52 therein. In embodiments, fluid retention portion90 is formed from a porous material which includes openings or poresover at least a portion of a surface thereof. Examples include meshes,foams, and sponges. In other embodiments, fluid retention portion 90 isformed from an absorbent material. The absorbent material may be anynatural or synthetic cloth or felt material within the purview of thoseskilled in the art. A moisture wicking material that does not absorbmoisture into the fiber but maintains the moisture on the surfacethereof may also be used separately or in combination with a porous orabsorbent material. Examples include, for example, polyester,polyester-based fabrics, nylon, spandex, and blends or combinationsthereof. In embodiments, fluid retention portion 90 is fabricated from amesh of spandex. In other embodiments, fluid retention portion 90includes a nitinol wire frame and an absorbent material containedtherein.

As illustrated in FIG. 9, to use the scope cleaner 70 in connection withthe performance of a surgical task during a laparoscopic procedure,scope cleaner 70 is inserted onto the shaft of instrument 62. Fluid 52,such as FRED™ anti-fog solution, is applied onto fluid retention portion90 prior to insertion of the instrument 62 into the operating cavity. Ascope 60 is also introduced into the body cavity through a separateport. The desired surgical task is performed with scope 60 andinstrument 62. During manipulation of scope 60, should the scope 60 fog,become soiled, accumulate debris, or obstruct the surgeon's view in anyway, scope 60 is moved in contact with fluid retention portion 90 ofscope cleaner 70. With the application of light pressure, the scope 60is moved in a clockwise/counterclockwise motion in order to clean scope60.

It will be understood that various modifications and changes in form anddetail may be made to the embodiments of the present disclosure withoutdeparting from the spirit and scope of the disclosure. Therefore, theabove description should not be construed as limiting the invention butmerely as exemplifications of embodiments thereof. Those skilled in theart will envision other modifications within the scope and spirit of thepresent disclosure as defined by the claims appended hereto.

1. A surgical access device comprising: a housing; a sleeve extendingdistally from the housing and defining a longitudinal axis, the sleevedimensioned for passage through a tissue tract, the sleeve defining alongitudinal bore for reception and passage of a surgical instrument;and a conduit having a first portion configured to receive a fluid and asecond portion configured to discharge the fluid, the second portion ofthe conduit disposed in mechanical cooperation with the sleeve andpositioned to direct the fluid against the surgical instrument duringpassage thereof through the longitudinal bore.
 2. The device of claim 1wherein the second portion of the conduit is configured as a nozzle. 3.The device of claim 1 wherein the second portion of the conduit isconfigured as a proximally-facing nozzle.
 4. The device of claim 1wherein an elongated portion of the conduit is disposed adjacent thesleeve.
 5. The device of claim 1 wherein an elongated portion of theconduit is disposed within a wall of the sleeve.
 6. The device of claim1 wherein the conduit comprises channels.
 7. The device of claim 1wherein the housing includes a seal, the seal adapted to establish asubstantial sealed relation about the surgical instrument.
 8. The deviceof claim 1 including a source of cleaning fluid in fluid communicationwith the first portion of the conduit.
 9. A method of cleaning asurgical instrument including: providing a trocar assembly having aconduit operably coupled to a sleeve of the trocar assembly, the conduithaving a first portion for receiving a fluid and a second portion fordischarging the fluid; inserting a surgical instrument through thetrocar assembly; and discharging a fluid through the second portion ofthe conduit such that the fluid directly contacts a distal end of thesurgical instrument.
 10. The method of claim 9 further comprising thestep of attaching a source of cleaning fluid to the first portion of theconduit.
 11. An instrument cleaning apparatus comprising: a base portionincluding a substantially tubular wall having a proximal end and adistal end and a longitudinal passageway extending therethrough, thebase portion adapted for positioning on a surgical instrument; and afluid retention portion in mechanical cooperation with the base portion,the fluid retention portion configured to be contacted by a scope. 12.The instrument cleaning apparatus according to claim 11, wherein thebase portion includes a tab for gripping the base portion.
 13. Theinstrument cleaning apparatus according to claim 11, wherein the wall ofthe base portion includes a longitudinally extending slit.
 14. Theinstrument cleaning apparatus according to claim 11, wherein the fluidretention portion is disposed within the wall of the base portion. 15.The instrument cleaning apparatus according to claim 11, wherein thefluid retention portion radially extends from the wall of the baseportion.
 16. The instrument cleaning apparatus according to claim 11,wherein the fluid retention portion comprises a porous material selectedfrom the group consisting of meshes, foams, and sponges.
 17. Theinstrument cleaning apparatus according to claim 11, wherein the fluidretention portion comprises an absorbent material.
 18. The instrumentcleaning apparatus according to claim 11, wherein the fluid retentionportion comprises a fluid wicking material.
 19. The instrument cleaningapparatus according to claim 11, wherein the fluid retention portion isadapted to retain a cleaning solution therein.